Parents debating sleep training can rest (literally and figuratively) easy. New data out today in Pediatrics found that letting babies cry-it-out (CIO) or self-soothe does not increase signs of stress compared with babies who don’t. The study out of Australia tested two sleep training methods: “graduated extinction” (parents leave and return at increasing intervals of time, AKA one version of CIO) and “bedtime fading” where parents shifted bedtimes based on how long it took babies and young toddlers to fall asleep. The groups of babies and their moms were compared to those in a control group of babies and moms/dads who received only sleep education. The group in total was small, some 43 infants spanning 6 months to 16 months randomized into the three groups. I was fortunate to be able to discuss the study and what it means for parents on The TODAY Show this morning. In addition, I chatted about the study design, findings, and implications with Dr. Maida Chen, the Director of the Seattle Children’s Sleep Center. We were both excited as the study evaluated baby’s sleep, tracked their sleep with actigraphs (movement monitors), evaluated sleep by parental sleep diaries, measured morning and afternoon cortisol levels (a stress hormone) and tracked time to fall asleep, number of nighttime awakenings, total sleep time, mom’s stress, mom’s mood and long-term bonding. Even though the study may have some limitations (very small sample size and parents self-selected to the study with sleep concerns therefore it may be non-representative of parents at large who AREN’T worried about sleep) the randomization to the three groups and the measures studied boost the exciting results.

6 Take-Aways From The Baby Sleep Study

  1. No matter the sleep training method, moms reported feeling less stressed. Huge win! Moms showed significant reduction in stress in the two groups who used sleep training compared with the control group of moms.
  2. Babies allowed to CIO showed no more signs of stress (cortisol levels — a stress hormone– measured in the morning and afternoon) than babies who were sleep-trained via other two methods.
  3. The CIO method (graduated extinction) proved better in reducing the number of times the infants woke during the night, as well as the amount of time they spent awake during the night. Babies in the study who were allowed to CIO slept roughly 20 more minutes at night.
  4. The method known as “bedtime fading” means putting your infant to bed a little later each night (if infants took longer than 30 minutes to fall asleep) in the hopes that they will fall asleep quicker if more tired. Bedtime fading proved to help babies fall asleep quicker, but did not show as many benefits as CIO in regards to awakenings at night and total sleep time. Tip: can use different techniques to help with different challenges.
  5. No matter the sleep training method, there were no differences in behavioral issues and/or bonding with mom. In addition, no matter the sleep method or education control group, there were no differences in mom’s overall mood.
  6. All babies, over time, improved their sleep reflective developmental progress. In addition, babies were found to awaken at times (on actigraphs, the baby movement trackers) and not cry out for help. Researchers interpreted this as successful self-soothing.

The Bottom Line: Babies who are sleep trained tend to sleep better — those given a chance to self-soothe . There are a variety of methods in the sleep training toolkit, allow yourself some time to research the options and select one that matches your family’s style and values. You can even try combining different methods.

Mama Doc Tips For Considering Sleep Training And Cry-It-Out

  • The study out today finds that babies may be no more stressed if using techniques that rely on crying-it-out versus some more gentle bedtime shifts or in the control group. Letting your baby learn to self-soothe does decrease night awakenings and increases sleep. It also reduces a mom’s stress! WIN-WIN.
  • Consistency from night to night is key. Your consistency with the sleep routine is far more important than what method you choose to help get your baby to sleep. The ritual at bedtime (reading, bath, rocking, etc) is one of the most important daily activities you establish for your child from day 1 (or day 30). Choose a method that matches your philosophies.
  • Letting your baby learn to fall asleep all on her own at 1 to 2 months of age will serve you and your child again and again. Try this at naptime or bedtime. Put your babies to sleep on their backs in a bare crib while still awake but drowsy. They will learn how to drift off without you! Research shows that infants and children who are allowed to learn to self-soothe and get themselves to sleep will often be far better sleepers, even as adults.
  • If you’re concerned about your baby’s sleep challenges, talk directly with their doc. Research found that 1 in 10 children under age 3 has a sleep challenge, and often sleep trouble persists from infancy to toddlerhood.
  • Sleep needs to be a priority (for us all). Making sacrifices to have consistent bedtimes from early infancy that support routine bedtimes and sleep routines will always be worth it. For you and your child.
  • After your baby is 4 months of age consider letting them self-soothe and get themselves back to sleep after they awaken. Although babies will often wake up 5-10 times nightly, they won’t always need you to fall back asleep. Babies need practice learning how to get themselves to sleep on their own.
  • Swaddling can be a great way to soothe babies. It’s okay to swaddle infants and put them on their back to sleep in early infancy but it’s not recommended to START swaddling a baby older than 4 months. And it’s good to be out of swaddles once a baby shows signs they are able to roll around 3-5 months. (more info in this recent blog post on new data that swaddling babies on side or tummy increases SIDS rates)
  • 10 reasons babies wake up at night